At OFP Dental Clinic, we are doing our best to maximize the treatment effects by using various therapies to promote the healing of the damaged area and recover its function.

 

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Physical Therapy

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Integrated physical therapy at the clinic

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• Percutaneous nerve stimulation and low-frequency treatment: It is used to relieve acute or chronic musculoskeletal pain, relieve pain after surgery, and relieve pain after excessive muscle use through non-invasive percutaneous nerve stimulation.

 

• ​Ultrasound therapy: This is a physical therapy is known for increasing tissue temperature and metabolism, promoting blood circulation, relaxing convulsive or adhered tissue, decreasing inflammatory substances, and reducing swelling.

 

 

• Laser treatment: Laser therapy has following effects: promote healing of damaged areas, reduce swelling, reduce pain, produce collagen, change the speed of DNA synthesis, promote superficial blood vessel formation, increase nerve activity, increase damaged peripheral nerve function, and promote the formation of collateral nerves to regenerate.

 

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Self-exercise and physical therapy education

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• Self-exercise therapy: This is a posture-related exercise therapy developed for patients with TMJ and head and neck pain. It consists of tongue stability, jaw joint rotation, neck joint stability, neck straightening, neck exercise, and shoulder posture.

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• Heat/Cold stimulation therapy: Superficial heat expands skin blood vessels and increases local circulation, thereby reducing harmful inflammatory metabolites. In case of muscle spasms, this application decreases the activity of gamma centrifugal motor neurons and induces a relaxation effect.

 

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Non-surgical Injection Therapy

 

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Dr. Kim, Hyoung Jun DDS, Ph.D. is well known for his exceptional clinical experience treating patients with non-traumatic treatments and non-surgical temporomandibular joint cavity injections.

OFP Dental Clinic provides relief to TMD and orofacial pain and most effective treatment results. With anatomical and physiological knowledge and state-of-art technology of CBCT scan and ultrasound guided treatments, Dr. Kim’s non-surgical injection will maximize the healing effect and minimize tissue damage and deterioration.

 

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Pain inducing point (TPI) injection treatment

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• What is trigger point injection (TPI) treatment? It is an injection therapy to treat muscle cramps and pain occurring in the jaw, head, neck muscles and fascia related to the jaw joint. It is also used for TMD by muscle tension.

• It stimulates the muscles to relax by inserting an injection needle into the muscle fibers and relaxes micromuscular spasm. At this time, an anesthetic drug is injected to numb the pain while needle is being inserted.

• TPI injection Mechanism of Action: By accurately inserting a needle into the microscopic muscle fibers that cause muscle spasms, it relaxes the muscles, improves blood circulation, and calms the sensitized nerves.

• Indication for TPI injection: myofascial pain around the jaw joint, myofascial pain in the neck and shoulders, muscle pain

• Precautions during the procedure: There are some patients who immediately relieve muscle pain, but it is usually performed in combination with other physical therapy or medication to maximize the therapeutic effect.

 

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Steroid injection treatment

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• What is steroid injection therapy? In case of severe pain due to inflammation in the jaw joint, steroid injection therapy may relieve the inflammation and pain by injecting a steroid that has a strong anti-inflammatory action directly into the jaw joint cavity.

• Steroid injection Mechanism of Action: Steroid injection suppresses the secretion of arachidonic acid, thereby reducing the production of prostaglandin, which causes inflammation. Steroid has a strong anti-inflammatory effect in the area of ​​tissue damage and reduces pain. However, since it does not contribute to tissue regeneration and acts as an immunosuppressant, excessive use or long-term use may cause various side effects.

• Indication for Steroid injection: severe pain in the jaw joint, traumatic neuropathic pain, neuritis, epidermal neuroma in the oral cavity

• Precautions during the procedure: For pregnant women and patients with certain systemic diseases such as diabetes, use of steroid is restricted. And use of excessive amounts or long-term use may cause various side effects, so it should be consulted and performed by a specialist.

 

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Hyaluronic acid injection treatment:

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• What is hyaluronic acid injection treatment?  Hyaluronic acid injection restores lubrication in the joint cavity and provides nutrients to protect the joint and helps restore the function of the jaw joint. Unlike steroid injection therapy, there is no specific side effect or rejection, so there is no limit to the number of procedures.

• Hyaluronic Acid Injection Mechanism of Action: When inflammation occurs due to tissue damage in TMJ, inflammatory cytokines reduce the synovial fluid in the joint cavity and increase friction. In this case, pain in the jaw increases, movement of the TMJ is slowed, followed by damage to the surrounding tissues. Hyaluronic acid injection protects and enhances the function of rubbing tissues in TMJ, helping to recover and adapt to the posterior tissue of the joint disc, especially in damaged joints.

• Indication for Hyaluronic acid injection: Locked jaw, trismus (when the mouth is difficult to open due to noise or jamming when opening the mouth), degenerative osteoarthritis of the jaw joint

• Precautions during the procedure: There are no special side effects or rejection reactions, but pregnancy, lactation, and allergies should be checked before a professional diagnosis and procedure.

• Usually, 3-6 times injection needed for therapeutic results.

 

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Tissue Regenerative Therapy Injection Treatment

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• What is Tissue Regeneration (TRT) Injection treatment?  TRT injection induces tissue regeneration and healing and acts as an anti-inflammatory substance reducing inflammation and pain. The risk of side effects and infection is very low.

• TRT injection treatment Mechanism of Action: stimulates growth factors such as fibroblasts and collagen to promote cell proliferation and healing. In particular, it helps regeneration and strengthening of damaged ligaments in the jaw joint where blood circulation is limited. It can also protect against joint destruction by alleviating inflammation that destroys the cartilage and bones of the joint.  

• Precautions during the procedure: It usually takes 3-6 months for tissue regeneration in the TMJ, and in the case of severely damaged TMJ patients, it may take more than 2 years.

• Usually, 5-6 times injection needed for therapeutic results

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Botox (Botulinum toxin type A) injection therapy

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• What is Botulinum Toxin Injection Therapy? Botulinum toxin is a treatment that reduces the volume of muscles around the TMJ and decreases muscle contraction by inhibiting the secretion of neurotransmitters involved in muscle contraction by direct injection into the muscle.

• Botulinum toxin injection Mechanism of Action: Botulinum toxin  reduces the mass and contractile power of the masseter and temporal muscles that exert excessive load on the jaw joint by inhibiting the secretion of acetylcholine, a neurotransmitter involved in the contraction of muscle fibers, for a certain period of time. . In addition, it is a treatment proven to be effective for migraine and dystonia by injecting to the frontal, occipital, cervical lateral muscles, sternocleidomastoid, trapezius, etc.

• Botulinum toxin injection Indication: TMJ and facial pain, dystonia of the jaw face, migraine, grinding, etc.

• Precautions during the procedure: Excessive dose or injecting into the blood vessels rather than the muscles, side effects may occur. Therefore, the required dose must be injected for the exact anatomical target by a specialist.

• Typically, the effective period is 3-4 months.

 

 

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TMJ Stabilization Device (SD)

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• What is a jaw joint stabilization device? It is a device that protects teeth, stabilizes joints, redistributes the force exerted on the masticatory system, relaxes the levator muscles, and reduces bruxism.

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• Treatment Mechanism of Stabilization Device: It covers the teeth to protect the teeth from parafunctional activities such as clenching and grinding. This occlusal stabilizing device is installed in the oral cavity to increase the patient's awareness of parafunctional habits and to induce muscle relaxation, thereby reducing the load on muscles and joints.

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• Precautions when wearing stabilization device : 

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• One week after the stabilization device is installed, you must visit the clinic to check whether the device is fit and adjust the occlusion of the device. Periodic exam to check the occlusion and the condition of the device is necessary.

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• TMJ stabilization device must be fabricated with durable dental hard acrylic material. The design of stabilization devices must be customized according to the anatomy of the mouth and occlusion of patients to provide a physiologically stable mandibular position. Accurate diagnosis and adjustment made by a specialist are critical to ensure its stability and effectiveness and to avoid any side effects. In the case of a soft type appliances, muscle activity via grinding may increase further, and it may cause irreversible malocclusion when worn for a long time. Therefore, diagnosis and treatment should be performed by an oral medicine orofacial pain specialist to determine types of device and durations.

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Snoring / Sleep apnea device (MAD)

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• What is a mandibular advancement device (MAD)? It is a treatment method using a device that expands the airflow passage when breathing by placing the mandible (lower jaw) forward.

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• MAD treatment Mechanism of Action: Position the mandible (lower jaw) forward, pull the tongue and sublingual muscles forward, and expand the space behind the tongue. In addition, it increases the activity of the geniohyoid muscle and stabilizes the pharyngeal wall to expand the airways, which are the channels of air flow during breathing.

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• MAD Appliance Indication: It is an effective treatment for patients with snoring, mild and moderate obstructive sleep apnea (OSA), and sleep apnea who have difficulty using continuous positive upper respiratory pressure (CPAP).

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• Precautions for the procedure:  It cannot be used for patients with jaw joint disorder, central sleep apnea, nasal obstructive sleep apnea, extensive tooth defects, severe periodontitis, and cardiovascular disease. In addition, if periodic occlusion and device status tests are not performed, the jaw may not return to its original position after removal of the device due to an open bite in the molar area and muscular dystrophy of the lower extremities. Therefore, MAD device treatment method requires diagnosis and treatment by an oral medicine orofacial pain specialist.